ACP urges members to reach out to legislators to encourage them to maintain implementation of G2211, work toward long-term reform of Medicare payments to physicians
Nov. 17, 2023 (ACP) -- The American College of Physicians is pleased by the final 2024 Medicare Physician Fee Schedule inclusion of a new code that better recognizes the resources necessary to provide patients with long-term, continuous care. However, ACP remains concerned about the long-term financial stability of Medicare and continued cuts in physician reimbursement rates.
“Overall payments to physicians are scheduled to be cut on Jan. 1, and it will take an act of Congress to stop these cuts,” said Dr. Omar T. Atiq, president of ACP. “Medicare payments to physicians have been flat for the past two decades, while inflation has risen.”
The good news is that the fee schedule implements G2211, an add-on code for office visits in office and outpatient evaluation and management services. ACP advocated for the code and offered guidance to the Centers for Medicare & Medicaid Services about its implementation.
“G2211 is intended to characterize the base service based on the kind of care being furnished to better account for the inherent complexity of these visits that would otherwise be unaccounted for,” said Brian Outland, ACP director of regulatory affairs. “CMS slightly revised the description of code G2211 to clarify that the code is intended to be used to account for the additional resources needed for patients who have serious conditions and a longitudinal relationship with their clinicians.”
ACP has spent years advocating for this type of code, which will allow clinicians to account for services like chronic disease management tracking, review of consultative or diagnostic reports, medication monitoring, safety outside of patient visits and physician input at assisted living or nursing homes.
In another development, CMS is finalizing a proposal to consolidate the previously finalized Promoting Wellness and Optimizing Chronic Disease Management Merit-Based Incentive Payment Systems (MIPS) Value Pathways (MVPs) into a single consolidated primary care MVP titled Value in Primary Care MVP, Outland noted. As a result, MVP participants will have a total of 16 MVPs available for the calendar year 2024 performance period/2026 MIPS payment year.
In the larger picture, ACP continues to be concerned about the future of Medicare and is urging Congress to support medical professionals. “For years, physicians have struggled with this broken Medicare payment system that does not allow them to keep up with rising practice expenses and the cost of providing care,” Atiq said. “The Physician Fee Schedule is the only part of Medicare that does receive annual adjustments for inflation; current Medicare physician payment rates have decreased by 26 percent since 2001 when accounting for inflation.”
The 2024 Medicare conversion factor is $32.74, a 3.4 percent decrease from the 2023 conversion factor. “Congress must step in to prevent the cut scheduled for Jan. 1 and find a long-term solution that would ensure that physicians are appropriately compensated for the care they deliver to our nation's seniors,” Atiq said. “We need a payment system that will support long-term reform -- including advancing health equity, enhancing access to care and improving the health and well-being of everyone enrolled in Medicare.”
However, Outland acknowledged that it is not likely the cuts will be averted this year.
ACP is strongly recommending that CMS and Congress work in collaboration with ACP and other interested parties for long-term reform.
“ACP has supported recently introduced legislation, the Strengthening Medicare for Patients and Providers Act, that would serve as a first step in correcting the issues with Medicare physician payments, but this alone will not be sufficient to solve the problem,” Outland explained.
What can ACP members do now to help with advocacy efforts regarding the 2024 fee schedule? “We continue to encourage members to make their voices heard and take action by urging Congress to do nothing to stop the implementation of the code G2211,” Outland said.
ACP members can find an action alert to help them advocate to members of Congress about Medicare payments on ACP's Legislative Action Center.